New Member - Steve & Alex & Advice on Regulation?

Alex Ocanas

Alex Ocanas

New Member
Hello! My name is Alex. My cat Steve was diagnosed with diabetes in January. Since then I have spent hours reading many of your posts and great advice. This resource has been better than what I was able to get from my vet (and I actually paid money for that!). Thanks to everyone who helps make this learning community possible.

We are only in the beginning stages but Steve, after weeks of insulin, does not seem to be experiencing a significant decline in average insulin values. He has started and generally stayed in the 300s. A link to his chart should be in my signature. Our vet delayed his transition to a low-carb kibble (he just transitioned a few days ago) and has yet to advise us to go past 2 units insulin/dose.

:cat::cat: I'm trying to be patient but.... is this normal for a kitty to take so long to respond well to insulin? Can anyone weigh in? It seems like something isn't working right and I'm eager to try something new and get him into a consistently lower, regulated level. He's still peeing like a race horse and his litter aint cheap! :p
 
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Alex Ocanas said:
Hello! My name is Alex. My cat Steve was diagnosed with diabetes in January. Since then I have spent hours reading many of your posts and great advice. This resource has been better than what I was able to get from my vet (and I actually paid money for that!). Thanks to everyone who helps make this learning community possible.

We are only in the beginning stages but Steve, after weeks of insulin, does not seem to be experiencing a significant decline in average insulin values. A link to his chart should be in my signature. Our vet delayed his transition to a low-carb kibble (he just transitioned a few days ago) and has yet to advise us to go past 2 units insulin/dose.

:cat::cat: I'm trying to be patient but.... is this normal for a kitty to take so long to respond well to insulin? Can anyone weigh in? It seems like something isn't working right and I'm eager to try something new and get him into a consistently lower, regulated level. He's still peeing like a race horse and his litter aint cheap! :p
Click to expand...
@Bron and Sheba (GA)
 
Hi Alex, other more experienced folks will be by I’m sure to offer you a bunch of information.

But one thing that jumps out at me quickly is the food.

That food is too high in carbs for a diabetic. We were on that food last year, switched to a low carb wet, and saw a nice shift down in numbers from similar numbers that you have now. Lots of people here feed Fancy Feast Pates but there are tons of options. Here’s a link to a food chart.
 
Diane Tyler's Mom GA said:
I see you have in your signature you are feeding
Purina Pro DM kibble which is 18% carbs which is way to high for a diabetic cat.
We don't increase by whole units at a time
We adjust the dose by 0.25 units at a time
Are you using the U-100 syringes with the half unit markings
Click to expand...

Yikes! Thanks, Diane and Tim. I thought I bought the food his vet suggested but clearly something went wrong along that line of communication.

My insulin pen only has 1 unit intervals and the changes we've made have each been directed by our vet. The needles are 31G / 0.25 mm
 
Syringes with half units markingsU100, 3/10 ml, 30 or 31 gauge, 6 or 8 mm insulin syringes with 1/2 unit markings
@Alex Ocanas

You need half unit markings . You can get them on Amazon without a vets script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO
@Alex Ocanas

You can also get the Relion Syringes at Walmart , you would need to go into the store to purchase them. I don't know if you will need a vets script

Walmart, you can get U100 insulin syringes with half unit marks for $12.58/100.
You need to go into the store to get them

Either of these 2 boxes are the ones you want (with a purple stripe). You have to go into the store , can't buy them on line
upload_2024-4-22_23-37-23-jpeg.69946





This was posted by a member and copied it for you
If you're going to Walmart, ask for Relion 3/10ml, 31 or 30 gauge insulin syringes. (Don't mention half unit marks because this tends to confuse them and they think you don't know what you want and will try to convince you that you need 1/2ml syringes---you DON'T)

ALL of the 3/10ml Relion syringes at Walmart have half unit marks. Trust me on this. You will want one of these boxes of syringes (the difference is the needle length...blue box are shorter needles than white box but both work fine). As long as the box has the purple stripe, they are the correct syringes.

Or any of these syringes

Using syringes with a pen, cartridge, or vial:
  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Levemir, or the Biosimilars from vials, cartridges, and pens.
  • BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
  • Syringes come in 5/64 inch (6mm), ½ inch (8mm) or 5/16 inch (12.7mm) needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest
You would probably need a vets script for these
I didn't like the monoject.

I always used the UltiCare Vet Rx from Amazon
You need half unit markings . You can get them on Amazon without a vets script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO
 
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The Kirkland pate might be low enough carb. We look for under 10%, but closer to 3-5% would be better. Seeing as it’s a newer food, I’d put the ingredient percentages into an online carb calculator to double check… how much of each food is he getting now?

There could be a few reasons the vet recommended the DM. Sometimes they don’t know better, maybe they don’t get many diabetics. Or, I’ve heard claims that some offices are incentivized to push certain brands.

There are some low carb dry foods too. I’m already stealing @Diane Tyler's Mom GA ’s thunder, so I’ll let her take over.

You’re doing a lot of stuff right though, so good job. Steve looks sweet. And welcome to the board!
 
Can you add SLGS to your signature like you have on your spreadsheet
You really need to be testing more after the PMPS cycle, you are only seeing half the picture
Cats often drop lower at night and you don't want to miss a reduction

If you must feed dry food
Young again on their web site
https://www.youngagainpetfood.com
Take a look at the young again zero or the zero mature. Some members have said the Young Again caused stinky poops

In the past I have used The Dr Elseys and had no problem

Dr Elsey's also at Walmart
https://www.walmart.com/ip/Dr-Elsey...ViI3ICh0suwO_EAQYAiABEgJrOPD_BwE&gclsrc=aw.ds

Dr Elsey's Amazon
https://www.amazon.com/dp/B07FCJHDPR/ref=twister_B09GHFJY65?_encoding=UTF8&psc=1

the Dr Elsey's comes in different size bags
None of these can be bought in stores

Also
Wysong Epigen 90

If you call they will send you samples
Phone: 877-311-2287… Dr Elsey's

PHONE:
800.311.6646. Young Again

1-800-748-0188 •Wysong Epigen 90

Carbohydrate amounts can be found on the Kibble Values Chart

https://www.drelseys.com/faqs/what-are-the-carbohydrate-amounts/

Tap on where it says Kibble Values Chart it will give you the carbs

@Alex Ocanas
 
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One other thing my more rested brain noticed this morning - it’s really important to test BG before each shot. I see you have some pre-shot tests blank. Otherwise we don’t know if it’s safe to shoot.
 
Welcome to FDMB.

We consider low carb food as under 10%. Most members feed their cat a variety of food that's in the neighborhood of 5%. There are lots of options. This chart that has the carb values for many, if not most of the canned foods available in the US may be helpful. This is a link to a popular cat food carb calculator. I've never seen the one Diane provided.

Most vets are not well trained in nutrition. Beyond the couple of hours (if that) that they get during vet school, most of their information comes from the pet food manufacturer's sales people. As a result, they tend to think that the prescription foods meet the dietary needs of a cat's particular condition, like diabetes. This is not the case. The pet food manufacturers lost a class action suit for misrepresenting the nature of the prescription food. If you look at the label for the DM, there's nothing in it that even vaguely resembles anything "prescriptive." There are only a very few dry foods that are low in carbs -- Dr. Elsey's Clean Protein and Young Again Zero Carb. You may want to take a look at this site on feline nutrition. There are some good explanations for feeding canned food vs kibble.

It looks like you were doing your reading on dosing methods? If not, this is the link to the dosing methods information for glargine. You would need to use SLGS given that Steve is eating dry food. Even with SLGS, you need to get at least one test every night during the PM cycle. Many cats experience lower numbers at night. Ideally, you should get at least 4 tests/day -- your AMPS and PMPS and then a minimum of one additional test during the AM and PM cycles. Testing is the best way to ensure that your cat is in safe numbers. A couple of the basics include that we recommend changing doses in 0.25u amounts. With SLGS, you evaluate the effectiveness of the dose on a weekly basis unless numbers drop below 90 and you need to reduce the dose. Glargine is not an insulin that crushes numbers down. It's gentle and forms a depot that gives it a long duration. You might want to review the sticky notes at the top of the Lantus forum so you have a feel for how the insulin works. In other words, managing your cat's diabetes is a marathon, not a sprint.
 
Tim & Pookey said:
Hi Alex, other more experienced folks will be by I’m sure to offer you a bunch of information.

But one thing that jumps out at me quickly is the food.

That food is too high in carbs for a diabetic. We were on that food last year, switched to a low carb wet, and saw a nice shift down in numbers from similar numbers that you have now. Lots of people here feed Fancy Feast Pates but there are tons of options. Here’s a link to a food chart.
Click to expand...

https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
Cat Food Nutrition Calculator | Elizabeth C Scheyder
 
I would use the carb calculator that Sienne suggested ,so I deleted the one I gave to you

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
Here is the food chart for low carb wet food. I do not know if the Kirkland pates are low carb
Most feed Fancy Feast Classic Pates or Friskies
Most feed around 6% or less
@Alex Ocanas

You can use a calculator to see if the Kirkland Pate which ever flavor you are using to find out how many carbs there are. They need to be under 10% carbs
 
Sienne and Gabby (GA) said:
Welcome to FDMB.

We consider low carb food as under 10%. Most members feed their cat a variety of food that's in the neighborhood of 5%. There are lots of options. This chart that has the carb values for many, if not most of the canned foods available in the US may be helpful. This is a link to a popular cat food carb calculator. I've never seen the one Diane provided.

Most vets are not well trained in nutrition. Beyond the couple of hours (if that) that they get during vet school, most of their information comes from the pet food manufacturer's sales people. As a result, they tend to think that the prescription foods meet the dietary needs of a cat's particular condition, like diabetes. This is not the case. The pet food manufacturers lost a class action suit for misrepresenting the nature of the prescription food. If you look at the label for the DM, there's nothing in it that even vaguely resembles anything "prescriptive." There are only a very few dry foods that are low in carbs -- Dr. Elsey's Clean Protein and Young Again Zero Carb. You may want to take a look at this site on feline nutrition. There are some good explanations for feeding canned food vs kibble.

It looks like you were doing your reading on dosing methods? If not, this is the link to the dosing methods information for glargine. You would need to use SLGS given that Steve is eating dry food. Even with SLGS, you need to get at least one test every night during the PM cycle. Many cats experience lower numbers at night. Ideally, you should get at least 4 tests/day -- your AMPS and PMPS and then a minimum of one additional test during the AM and PM cycles. Testing is the best way to ensure that your cat is in safe numbers. A couple of the basics include that we recommend changing doses in 0.25u amounts. With SLGS, you evaluate the effectiveness of the dose on a weekly basis unless numbers drop below 90 and you need to reduce the dose. Glargine is not an insulin that crushes numbers down. It's gentle and forms a depot that gives it a long duration. You might want to review the sticky notes at the top of the Lantus forum so you have a feel for how the insulin works. In other words, managing your cat's diabetes is a marathon, not a sprint.
Click to expand...

Thank you, Sienne! Yes, I'm getting the sense that my vet isn't totally caught up to best practices. If I relied only on what they've shared with me, I think I'd be totally lost. Thanks for all of these helpful links and points. :)
 
Tim & Pookey said:
The Kirkland pate might be low enough carb. We look for under 10%, but closer to 3-5% would be better. Seeing as it’s a newer food, I’d put the ingredient percentages into an online carb calculator to double check… how much of each food is he getting now?

There could be a few reasons the vet recommended the DM. Sometimes they don’t know better, maybe they don’t get many diabetics. Or, I’ve heard claims that some offices are incentivized to push certain brands.

There are some low carb dry foods too. I’m already stealing @Diane Tyler's Mom GA ’s thunder, so I’ll let her take over.

You’re doing a lot of stuff right though, so good job. Steve looks sweet. And welcome to the board!
Click to expand...
Thanks, Tim. I appreciate the encouragement and resources! I did not know a carb calculator existed, so I'll use that now! :)
 
Diane Tyler's Mom GA said:
Can you add SLGS to your signature like you have on your spreadsheet
You really need to be testing more after the PMPS cycle, you are only seeing half the picture
Cats often drop lower at night and you don't want to miss a reduction

If you must feed dry food
Young again on their web site
https://www.youngagainpetfood.com
Take a look at the young again zero or the zero mature. Some members have said the Young Again caused stinky poops

In the past I have used The Dr Elseys and had no problem

Dr Elsey's also at Walmart
https://www.walmart.com/ip/Dr-Elsey...ViI3ICh0suwO_EAQYAiABEgJrOPD_BwE&gclsrc=aw.ds

Dr Elsey's Amazon
https://www.amazon.com/dp/B07FCJHDPR/ref=twister_B09GHFJY65?_encoding=UTF8&psc=1

the Dr Elsey's comes in different size bags
None of these can be bought in stores

Also
Wysong Epigen 90

If you call they will send you samples
Phone: 877-311-2287… Dr Elsey's

PHONE:
800.311.6646. Young Again

1-800-748-0188 •Wysong Epigen 90

Carbohydrate amounts can be found on the Kibble Values Chart

https://www.drelseys.com/faqs/what-are-the-carbohydrate-amounts/

Tap on where it says Kibble Values Chart it will give you the carbs

@Alex Ocanas
Click to expand...
Amazing!!! Thank you, Diane, for all of these great suggestions and resources! I really appreciate it. :D
 
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